<div id="maincontainer2" align='center'>
<table cellspacing="0" cellpadding="0" class='printDetails' style='width: 500px;'>
	<tr>
		<td>{include file="print_patient/element_print_header.html"}</td>
		<td valign='top' style='text-align: right'>
			<img src='../images/bvct_logo_print.png' border='0'/> 
		</td>
	</tr>
</table>
<table cellspacing="0" cellpadding="0" class='printDetails' style='width: 500px; padding-top: 8px;'>
	<tr>
		<td colspan='2' style='text-align: center; border: none;'><span class='printHeader'>{translate}Prescription{/translate}</span></td>
	</tr>
    <tr>
    	<td class="field">{translate}Full name{/translate}: <span style='font-size: 1.1em; text-transform: uppercase'><b>{$person->getName()}</b></span></td>
        <td align='right' class="field">{translate}Patient's ID{/translate}: <span style='font-size: 1.1em'><b>{$patient->getPatientCode()}</b></span></td>
    </tr>
    <tr>
        <td class="field">{translate}Gender{/translate}: {if $person->getGender()=="male" } {translate}Male{/translate} {elseif $person->getGender()=="female"} {translate}Female{/translate} {/if}</td>
        <td align='right' class="field">{translate}Date of birth{/translate}: {$person->getDateofBirth()} (<b style='font-size: 1.1em'>{translate}Age{/translate}: {$person->getAge()}</b>)</td>
    </tr>
     <tr>
        <td colspan='2' class="field">{translate}Address{/translate}: {$person->getAddress()}</td>
    </tr>
</table>
<br />
<table border='0' cellspacing='0' cellpadding='0' class='printGrid2'>	
	<tr>
		<th valign='top' class='first' colspan='2'>&nbsp;</th>
		<th valign='top' width='150px' class="data">{translate}Right eye{/translate}</th>
		<th valign='top' width='150px' class="data">{translate}Left eye{/translate}</th>
	</tr>
	<tr>
		<td valign='top' class='first' colspan='2'>{translate}Errors of refraction{/translate}</td>
		<td valign='top' class="data">{$refraction->getRightRefrationType()}&nbsp;</td>
		<td valign='top' class="data">{$refraction->getLeftRefrationType()}&nbsp;</td>
	</tr>
	<tr>
		<td valign='top' class='first' colspan='2'>{translate}Currently corrected glasses{/translate}</td>
		<td valign='top' class="data">{$refraction->getRightCurrentDiopter()}&nbsp;</td>
		<td valign='top' class="data">{$refraction->getLeftCurrentDiopter()}&nbsp;</td>
	</tr>
	<tr>
		<td valign='top' class='first' colspan='2'>{translate}PD of currently corrected glasses{/translate}</td>
		<td valign='top' colspan='2' class="data">{$refraction->getCurrentKCTK()}&nbsp;</td>
	</tr>
	<tr>
		<td valign='middle' class='first' width='80px' rowspan='2'>{translate}Vision acuity{/translate}</td>
		<td valign='top' width='80px'>{translate}Without correction{/translate}</td>
		<td valign='top' class="data">{$commonInfo->getRightCVA()}&nbsp;</td>
		<td valign='top' class="data">{$commonInfo->getLeftCVA()}&nbsp;</td>
	</tr>
	<tr>
		<td valign='top' width='80px'>{translate}With correction{/translate}</td>
		<td valign='top' class="data">
			{$commonInfo->getRightUCVA()}&nbsp;			
		</td>
		<td valign='top' class="data">
			{$commonInfo->getLeftUCVA()}&nbsp;
		</td>
	</tr>
	<tr>
		<td valign='top' class='first' colspan='2'>{translate}Biocular vision{/translate}</td>
		<td valign='top' colspan='2' class="data">
			{$commonInfo->getBothEyesight()}&nbsp;
		</td>
	</tr>
	<tr>
		<td valign='top' class='first' colspan='2'>{translate}Eye glasses{/translate}</td>
		<td valign='top' class="data">{$refraction->getRightCorrectGlass()}&nbsp;</td>
		<td valign='top' class="data">{$refraction->getLeftCorrectGlass()}&nbsp;</td>
	</tr>
	<tr>
		<td valign='top' class='first' colspan='2'>{translate}Near vision{/translate} + Add</td>
		<td valign='top' class="data">{$refraction->getRightVisualAcuity()}&nbsp;</td>
		<td valign='top' class="data">{$refraction->getLeftVisualAcuity()}&nbsp;</td>
	</tr>
	<tr>
		<td valign='top' class='first' colspan='2'>Skiascopy</td>
		<td valign='top' class="data">{$refraction->getRightSkiascopy()}&nbsp;</td>
		<td valign='top' class="data">{$refraction->getLeftSkiascopy()}&nbsp;</td>
	</tr>
	<tr>
		<td valign='top' class='first' colspan='2'>{translate}Pupil distance (PD){/translate}</td>
		<td valign='top' colspan='2' class="data" style='font-size: 15px; font-weight: bold'>{$refraction->getInterocularDistance()}&nbsp;</td>
	</tr>	
	<tr>
		<td valign='top' class='first' colspan='2' style=' font-size: 15px; font-weight: bold'>{translate}Suggestive glasses{/translate}</td>
		<td valign='top' class="data" style=' font-size: 15px; font-weight: bold'>{$refraction->getRightSuggestion()|nl2br}&nbsp;</td>
		<td valign='top' class="data" style='font-size: 15px; font-weight: bold'>{$refraction->getLeftSuggestion()|nl2br}&nbsp;</td>
	</tr>
</table>
<table border='0' cellspacing='0' cellpadding='0' class='printGrid2' style='margin-top: 5px;'>
	<tr>
		<td valign='top' style='text-align: left; border: none; border-bottom: 1px solid #000; width: 290px'><b><u>{translate}Description{/translate}:</u></b><br/>{$refraction->getNote()|nl2br}</td>		
		<td style='text-align: right; border: none; border-bottom: 1px solid #000; width: 200px'>
			<div align='center' style='padding: 5px 0px 5px 0px;'>
				<span>{translate p1=$refraction->getDate('created')}Date %s{/translate}</span><br/>
				<span>{translate}Optometrist{/translate}</span>
				{if $printSignature=='yes'}
				<br/>
				<img src="{$signature_url}" style='border: none; padding-top: 5px; padding-bottom: 5px;max-width: 90px; height: 75px;'/>
				<br/>
				{else}
				<br/><br/><br/><br/><br/><br/><br/>	
				{/if}
				<span>{translate p1=$refraction->getDoctorName()}KTV.%s{/translate}</span>
			</div>
		</td>
	</tr>
	<tr>
		<td colspan='4' style='text-align: left; border: none;'>
			*{translate}Please bring the prescription for the re-examinations{/translate}
		</td>
	</tr>
</table>
</div>